Catherization system and method

ABSTRACT

An artery blockage removal system including a hollow plastic tube with IR optical fibers extending longitudinally between its inner and outer walls, the end of the tube having a metal clad tip ring preferably of gold abutting against the end of the IR optical fibers, and the outer surface of the hollow plastic tube having curved arterial guards molded into its outer circumference to hold the inner walls of the artery away from the hollow plastic tube and metal clad tip ring to avoid physical and thermal damage to the inner artery walls, whereby arterial blockage is removed through application of the metal clad tip ring heated by the IR optical fibers and a vacuum applied through the center of the hollow tubing.

RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 10/302,076, filed Jan. 22, 2002.

FIELD OF THE INVENTION

The invention is related generally to catherization systems, and moreparticularly to an IR optical fiber catherization system for dislodgingarterial blockage and removing resulting arterial debris throughapplication of a vacuum without any damage occurring to artery walls.

BACKGROUND OF THE INVENTION

Systems for removing arterial debris are known which vary from use oflasers, heated coils, or stents for vaporizing arterial blockage, tomechanical devices such as vibrating conical sandpaper for abrading,so-called nibbler chomping pistons for biting, or rotating blades forcutting the blockage away from the artery walls.

An Excimer Laser Coronary Angioplasty system and procedure offered bySpectranetics of Colorado Springs, Colo., involves the insertion into anartery of a laser catheter containing a bundle of optical fibers and astent with a guide wire. The laser catheter is advanced in the arteryuntil the guide wire crosses a blockage, at which time bursts ofultraviolet (cool) laser light is transmitted through the fiber opticfibers to open a hole in the blockage. Thereafter, an x-ray contrast dyeis injected into the blood stream to determine the extent to which theartery has been opened. This procedure does not remove substantialamounts of blockage because ultra violet radiation is too cool to meltthe blockage. Rather, a hole is blasted through the blockage toaccommodate the admission of a stent. While the catherization systemincludes a filter, the filter is not sufficient to catch all debriswhich may flow downstream.

Such prior systems have failed because they have not effectively removedarterial blockage from the artery walls, and have not effectivelyremoved arterial debris from the artery once the arterial blockage hasbeen dislodged. In addition, such prior systems have not adequatelyprotected the artery walls from physical or thermal injury. Further,many of the prior art devices embody numerous parts which tend to failor shatter in a high temperature/high vacuum environment.

In the catherization system of the present invention, infrared radiationis used to vaporize arterial blockage and remove it from the arterywalls, and arterial guards are used to protect the artery walls fromphysical and thermal injury. Further, a vacuum chamber is formed withinthe inner walls of a hollow cylindrical tube comprising thecatherization system to remove all arterial debris before it can flowinto the body blood stream.

SUMMARY OF THE INVENTION

The present invention is directed to an IR (infrared) optical fibercatherization system and method for dislodging blockage from arterywalls without injury to the artery. The catherization system includes acentral vacuum passageway for removing the resulting arterial debrisfrom the artery to prevent injury caused by such debris entering themain blood stream of the body. The catherization process includes thefollowing steps: X-Ray dye is injected into an artery to pinpoint thelocation of a blockage; a guidewire of the catherization system isinserted into the artery to cross the location of the blockage; thecatherization system is advanced along the guide wire to abut theblockage; IR and vacuum sources are activated respectively to dislodgethe blockage from the artery walls and remove arterial debris withoutdamage to the artery and without risk of debris entering the body bloodstream.

In one aspect of the invention, the catherization system of the presentinvention is comprised of a hollow cylindrical tube having a metal cladtip ring at one end, with the circumference of the ring most distantfrom the end of the tube being larger than the circumference of the ringabutting the end of the tube.

In a further aspect of the invention, arterial guards are molded intothe outer surface of the hollow cylindrical tube and have curved flangesextending outward in parallel to the latitudinal axis of the tube toabut the artery walls without injury to the artery. The arterial guardshold the artery walls away from the metal clad tip ring to avoid heatinjury to the inner artery walls, and create blood stream flow paths inaddition to the central vacuum passageway of the hollow tubing.

In another aspect of the invention, IR optical fibers extend along thelongitudinal axis between the inner and outer walls of the hollowcylindrical tube and abut the lower surface of the metal clad tip ringto heat the ring sufficiently to vaporize arterial blockage.

In still another aspect of the invention, the metal clad tip ring ispreferably of gold for efficient heat transfer, and the outer surface ofthe hollow cylindrical tube is coated with Teflon to further avoidthermal injury to the inner artery walls.

In a still further aspect of the invention, the ends of the IR opticalfibers abutting the lower surface of the metal clad tip ring arepositioned equidistant from the ring's center and are separated byequidistant arcs along a circular path between the inner and outercircumferences of the metal clad tip ring.

In yet another aspect of the invention, the hollow cylindrical tube andIR optical fibers are made of IR specific plastic to avoid splinteringin a high temperature/high vacuum environment.

BRIEF DESCRIPTION OF THE DRAWINGS

Additional objects, features and advantages of the present inventionwill become apparent from the following detailed description when readin conjunction with the accompanying drawings in which:

FIG. 1 is a cross-sectional view along 1-1 of FIG. 2 of a firstembodiment of the present invention with arterial guards;

FIG. 2 is a cross-sectional view of the embodiment of the presentinvention illustrated in FIG. 1 along its latitudinal axis;

FIG. 3 is a cross-sectional view of a second embodiment of the presentinvention along its longitudinal axis that shows a longitudinaldisplacement between the metal clad tip ring 14 and the IR opticalfibers 13 a, 13 b, 13 d, and 13 e to provide added flow paths into theinterior of hollow cylindrical tube 10;

FIG. 4 is a cross-sectional view along the longitudinal axis of a thirdembodiment of the present invention which is used in combination with astent;

FIG. 5 is a side view of an arterial guard used in conjunction with thepresent invention as depicted in FIGS. 1-3 above;

FIG. 6 is a top view of the arterial guard of FIG. 5; and

FIG. 7 is a functional block diagram of the electrical, IR, and vacuumsource support system which is used with the embodiments of theinvention illustrated in FIGS. 14 in an operating room environment.

DESCRIPTION OF PREFERRED EMBODIMENTS

Preferred embodiments of the invention will now be described withreference to the accompanying drawings.

The following definition, whether occurring with capitalizations or inlower case, is used consistently throughout this specification indisclosing the invention:

“Stent” shall mean a coil comprised of an alloy such as nickle-titantiumor stainless steel, which works in conjunction with an internalangioplasty balloon to expand the stent to the walls of an artery.

Referring to FIG. 1, a hollow cylindrical tube 10 having a wallthickness of the order of 0.25 millimeters, and an outer circumferenceof the order of 1.5 millimeters is shown inserted into an artery 11. Anartery generally has an inner wall diameter of the order of 2.00millimeters. A 0.25 micrometer Teflon coating 12 covers the outersurface of the hollow cylindrical tube 10. IR optical fibers 13 a, 13 b,13 d, and 13 e are shown to be pneumatically sealed between the innerand outer walls of the hollow cylindrical tube 10, and extend thelongitudinal length of the tube to abut the lower surface of a metalclad tip ring 14. Arterial guards 15 a and 15 b are molded into theouter surface of the hollow cylindrical tube 10 and act to separate theinner artery walls from the tube and the metal clad tip ring 14. In theembodiment of FIG. 1, the upper end of the arterial guards is alignedhorizontally with the upper end of the hollow cylindrical tube 10.

The hollow cylindrical tube 10 with outer Teflon coating 12; IR opticalfibers 13 a, 13 b, 13 d, and 13 e; metal clad tip ring 14, and arterialguards 15 a and 15 b comprise a first embodiment of the catherizationsystem of the present invention.

The hollow cylindrical tube 10 with arterial guards 15 a and 15 b, andwith pneumatically sealed IR optical fibers 13 a, 13 b, 13 d, and 13 e,may be commercially formed of a flexible polyvinyl chloride (DEHP) typeof plastic by any of numerous plastic product manufacturers such asPLAS-LABS of Lansing, Mich. The metal clad tip ring 14 is preferablygold, and may be manufactured commercially by any of numerousmetallurgists including those generally used by hospitals.

In operation, dye is inserted into the artery 11 to pinpoint the exactlocation of artery blockage by X-ray. The catherization system generallyreferred to by reference number 16 thereafter is inserted into theartery 11, and the metal clad tip ring 14 is pushed against the arteryblockage to be removed. A vacuum is then created within the inner wallsof the hollow cylindrical tube 10, and an IR source is activated toirradiate the metal clad tip ring 14 by way of the optical fibers 13 a,13 b, 13 d, and 13 e. The IR optical fibers are raised to a temperaturein excess of 172 degrees Fahrenheit to heat the metal clad tip ring 14and thereby thermally cut a passage through the artery blockage. Thevacuum created in the hollow cylindrical tube 10 is in the range of 12to 14 inches of mercury, and accommodates a blood current by whichartery debris resulting from the above operation is removed through thelongitudinal passageway created by the inner walls of the tube withoutallowing any debris to escape to the body blood stream. During the aboveprocess, the artery guards 15 a and 15 b allow blood to flow around thecatherization system 16 to downstream tissues. Upon the artery debrisbeing removed, the catherization system 16 is removed from the artery11, which is restored to its normal functions.

Referring to FIG. 2, a cross-section along the latitudinal axis of theembodiment of the invention illustrated in FIG. 1 is shown. Thecatherization system 16 is shown inserted into artery 11, with ends ofIR optical fibers 13 a-13 f abutting the lower surface of the metal cladtip ring 14. The optical fibers 13 a-13 f are spaced apart by 60 degreesabout a latitudinal circumference between the inner and outer walls ofthe hollow cylindrical tube 10. The inner wall of the artery 11 isspaced apart from the metal clad tip ring 14 by the arterial guards 15a-15 d, which are separated by 90 degrees around the outer circumferenceof the hollow cylindrical tube 10. The arterial guards protect the innerwalls of the artery from thermal as well as physical damage during acatherization process, and allow blood flow around the catherizationsystem during a debris removal process.

In operation, the catherization system 16 is inserted into artery 11with the IR optical fibers 13 a-13 f abutting the underside of the metalclad tip ring 14. As the catherization system 16 is moved againstarterial blockage in the artery 11, the arterial guards 15 a-15 d havingcurved flanges hold the inner walls of the artery from contact with thehollow cylindrical tube 10 and metal clad tip ring 14, thereby avoidingphysical and thermal damage to the artery. The artery is furtherprotected by the Teflon coating 12 on the outer surface of the hollowcylindrical tube 10. When the metal clad tip ring 14 is heated by the IRoptical fibers to a temperature of the order of 172° Fahrenheit, apassage is thermally cut through the arterial blockage without damagingthe artery. As the artery blockage is dislodged, artery debris iscreated which is removed by means of a vacuum created in thelongitudinal passageway formed by the inner walls of the hollowcylindrical tube 10. Upon the artery debris being removed, thecatherization system 16 is removed from the artery 11, which resumes itsnormal functions.

FIG. 3 illustrates an embodiment of the invention in which increasedblood flow paths are created for a less restricted blood flow during thecatherization process. The catherization system 17 of FIG. 3 differsfrom the catherization system 16 of FIG. 1 only by a longitudinalseparation in the range of 1 to 2 millimeters being inserted between theunderside of the metal clad tip ring 14 and the upper end of the hollowcylindrical tube 10. More particularly, the uppermost end of the opticalfibers as represented by reference numbers 13 a, 13 b, 13 d, and 13 eare fabricated into the underside of the metal clad tip ring 14 to holdthe metal clad tip ring separate from the hollow cylindrical tube 10. Afurther blood current path 18 is thereby created into the hollowcylindrical tube 10 for removal of the arterial debris by means of avacuum being created within the hollow cylindrical tube 10 as beforedescribed.

FIG. 4 illustrates a third embodiment of the invention as used inconjunction with a stent. The catherization system 20 differs from thecatherization system 16 of FIG. 1 only by the absence of arterial guardsand Teflon coating 12, and the design of the metal clad tip ring 22.Referring to FIG. 4, a stent 21 is first inserted into the artery 11 toabut any arterial blockage previously found by use of an X-ray dye. IRoptical fibers as represented by reference numbers 13 a and 13 b areshown to be pneumatically sealed between the inner and outer walls ofthe hollow cylindrical tube 10, and extend the longitudinal length ofthe tube to abut the lower surface of the metal clad tip ring 22. Inoperation, the stent 21 is pressed against the inner walls of the artery11 through use of a water filled balloon internal to the stent.Thereafter, the catherization system 20 is advanced into the stent 21 toabut the artery blockage. A vacuum is then created within the innerwalls of the hollow cylindrical tube 10, and an IR source is activatedto irradiate the metal clad tip ring 22 by way of the optical fibers 13a and 13 b. The IR optical fibers are raised to a temperature in excessof 172 degrees Fahrenheit to heat the metal clad tip ring 22 and therebythermally cut a passage through the artery blockage. The increasedsurface areas 22 a and 22 b of the metal clad tip ring 22 ensure thatthe entry into the interior of the hollow cylindrical tube 10 does notbecome clogged by arterial debris. A vacuum in the range of 12 to 14inches of mercury is created in the hollow cylindrical tube 10 to form ablood current by which artery debris resulting from the above operationis removed through the longitudinal passageway created by the innerwalls of the hollow cylindrical tube 10. No arterial debris is allowedto escape to the body blood stream.

Referring to FIG. 5, a side view of arterial guard 15 b of FIG. 1 isshown. As before stated, the arterial guard 15 b, which isrepresentative of arterial guards 15 a-15 d, is formed to the outersurface of the hollow cylindrical tube 10. All edges of the arterialguard 15 b are rounded to avoid any physical damage to the inner wallsof the artery. Again referring to FIG. 5, an upper surface 23 of thearterial guard extends a horizontal distance of 0.25 millimeters fromthe outer surface of the hollow cylindrical tube 10. The upper surface23 is formed as an arc of a circle having a radius of 0.50 millimeters.A surface 24 of arterial guard 15 b is formed as an arc of a circlehaving a radius of 0.50 millimeters. A vertical distance 25 along theouter surface of the hollow cylindrical tube 10 and between uppersurface 23 and surface 24 is 1.0 millimeters.

Referring to FIG. 6, a top view of the arterial guard 15 b is shownwherein an outer surface 28 at its furthest point is a distance of 0.25millimeters from the outer surface of the hollow cylindrical tube 10.The outer surface 28 is formed as an arc of a circle having a radius of0.50 millimeter. The surfaces 26 and 27 of the arterial guard 15 b areformed as arcs of a circle having a radius of 0.625 millimeters.

FIG. 7 is a functional block diagram of a support system (which includesan IR source and a vacuum system) that services the metal clad tip ring14 of FIGS. 1-3 and metal clad tip ring 22 of FIG. 4. More particularly,an IR laser control box 30 with control dial 30 a and output node 30 bapplies infrared radiation to the IR optical fibers 13 a and 13 b whichare sealed between the inner and outer walls of the hollow cylindricaltube 10, and which abut the underside of a metal clad tip ring asillustrated in FIGS. 1-4. Referring again to FIG. 7, the control box 30is electrically connected by way of a conducting line 30 c to a 110 voltAC source. Control box 30 may be any of numerous well known laser sourceproducts including those offered commercially by LUMENIS of Salt LakeCity, Utah.

A vacuum control box 31 with control dial 31 a is connected by way of apneumatic connector 31 b to a central vacuum source, and by way of apneumatic connector 31 c to a vacuum tube 32. A port 33 with pneumaticseal 33 a and a port 34 with pneumatic seal 34 a lead to the internalpassageway of the hollow cylindrical tube 10. A guide wire 35 isinserted through the pneumatic seal 33 a and advanced into the hollowcylindrical tube 10 and through any arterial blockage. X-ray contrastdye is inserted by syringe through the pneumatic seal 34 a.

An electrical on/off switch 36 and an open/close pneumatic switch 37respectively control the application of the IR laser energy and vacuumto the hollow cylindrical tube 10. More particularly, the electricalswitch 36 is electrically and physically connected by way of aconducting wire 38 to the on/off input of IR laser control box 30. Theopen/close pneumatic switch 37 in turn is pneumatically sealed to theinner walls of the hollow cylindrical tube 10, and is physicallyconnected by way of a control wire 37 a to a control lever 39. Thecontrol wire 37 a moves up and down through a pneumatic seal in the wallof the hollow cylindrical tube 10. When the lever 39 is depressed, theelectrical switch 36 applies an internal battery voltage by way ofconducting wire 38 to activate the IR laser control box 30. Infraredradiation is thereupon applied through the optical fibers 13 a and 13 bto heat up a metal clad tip ring to the temperature specified by thecontrol dial 30 a. Simultaneously upon depressing lever 39, theopen/close switch 37 is forced to open the interior passageway of thehollow cylindrical tube 10 to the vacuum applied by way of vacuum tube40 to draw arterial debris out of the hollow cylindrical tube 10 andinto a collection vessel 41. The vacuum tube 40 is pneumatically sealedat one end to the inner walls of hollow cylindrical tube 10, and isinserted through a pneumatic seal 41 a into the collection vessel 41.The previously described vacuum tube 32 also is inserted through thevacuum seal 41 a into the collection vessel 41.

When the lever 39 is raised, the electrical switch 36 ceases to apply avoltage to the conducting line 38. The IR laser control box 30 isthereby turned off. Simultaneously upon raising the lever 39, theopen/close switch 37 is closed to prevent the vacuum applied by way ofvacuum control box 31, pneumatic connector 31 c, vacuum tube 32,collection vessel 41, and vacuum tube 40 from being applied to theinterior of the hollow cylindrical tube 10.

In operation, the catherization system of the present inventioncomprising the hollow cylindrical tube 10 is inserted into an artery.X-ray contrast dye is inserted by syringe into the hollow cylindricaltube 10 by way of port 34 to pinpoint the location of any arterialblockage by means of X-Ray exposure. The guide wire 35 is insertedthrough the pneumatic seal 33 a and advanced through the port 33 intothe hollow cylindrical tube 10 past the arterial blockage. Thecatherization system embodiment comprising the hollow cylindrical tube10, optical fibers 13 a and 13 b, and a metal clad tip ring asillustrated by any of the embodiments illustrated in FIGS. 1-4 isadvanced along the guide wire 35 to abut the artery blockage. Thecontrol dials 30 a and 31 a thereafter are respectively set to thedesired temperature and vacuum. The lever 39 then is depressed toactivate the IR laser control box 30 and to open switch 37. In responsethereto, the IR laser control box applies infrared radiation through theIR optic fibers 13 a and 13 b to heat the metal clad tip ring.Simultaneously, a vacuum is created within the inner walls of the hollowcylindrical tube 10. The IR optical fibers are raised to a temperaturein excess of 172 degrees Fahrenheit to heat the metal clad tip ring andthermally cut or vaporize the arterial blockage. The vacuum ispreferably in the range of 12 to 14 inches of mercury, and acts to drawinto collection vessel 41 any arterial debris resulting from the aboveoperation. More particularly, such debris is drawn out of the artery,through the longitudinal passageway created by the inner walls of thehollow cylindrical tube 10, and into the collection vessel 41 withoutallowing any debris to escape into the body blood stream.

Upon completion of the above operation, or as otherwise desired, thelever 39 may be raised to shut down the IR laser of the IR laser controlbox 30, and to close the open/close switch 37 to isolate the collectionvessel from the forward portions of hollow cylindrical tube 10. The dial31 a then may be rotated counterclockwise to turn the vacuum off, andthe collection vessel 41 may be disengaged from the pneumatic seal 41 ato empty out any arterial debris which has been collected. Thecollection vessel 41 then may be cleaned and sterilized, and reengagedto the pneumatic seal 41 a to conduct further arterial operations.

The present invention has been particularly shown and described indetail with reference to plural preferred embodiments, which are merelyillustrative of the principles of the invention and are not to be takenas limitations to its scope. Further, it will be readily understood bythose skilled in the art that numerous variations, changes, andmodifications may be made without departing from the spirit of theinvention. It is intended that the claims be interpreted to cover suchvariations, changes, and modifications.

1. An arterial catherization system for removing arterial blockage froman artery, which comprises: a cylindrical tube having a longitudinalpassageway and at least one port; an annular tip axially aligned andabutting said cylindrical tube to effect a thermal cutting of saidarterial blockage and to provide an entry into said longitudinalpassageway for removing arterial debris; and plural optical fiberspneumatically sealed within and extending along a longitudinal axis ofsaid cylindrical tube, and abutting said annular tip to accommodate aheating of said annular tip to a thermal cutting temperature.
 2. Thearterial catherization system of claim 1, wherein removal of saidarterial debris occurs through a vacuum in said longitudinal passageway.3. The arterial catherization system of claim 1, further includingarterial guards formed into and extending from an outer surface of saidcylindrical tube to separate inner walls of said artery from saidannular tip and outer walls of said cylindrical tube, thus avoidingphysical and thermal damage to said artery and providing blood pathwaysaround said arterial catherization system to downstream body tissue. 4.The arterial catherization system of claim 1, wherein said pluraloptical fibers are IR optical fibers.
 5. The arterial catherizationsystem of claim 1, wherein said annular tip is longitudinally separatedfrom said cylindrical tube to provide alternative pathways for blood toenter said longitudinal passageway.
 6. The arterial catherization systemof claim 1, wherein said annular tip has a first circumference adjacentsaid cylindrical tube which is smaller than a second circumference ofsaid annular tip which is further most from said cylindrical tube. 7.The arterial catherization system of claim 6, wherein said firstcircumference remains constant along said longitudinal axis a firstdistance and thereafter progressively increases to said secondcircumference, thereby providing an extended cutting surface to avoidclogging by said arterial debris.
 17. A catherization method forremoving blockage from an artery without damaging interior artery walls,which comprises the following steps: inserting dye into said artery topinpoint position of said blockage through X-Ray exposure; inserting aguidewire into said artery to extend through said blockage; advancing acatherization system having a central passageway and a thermal cuttingtip along said guidewire to abut said blockage; thermally cuttingthrough said blockage by irradiating said cutting tip without damagingarterial walls; and removing arterial debris resulting from the abovestep of thermally cutting by creating a vacuum in said centralpassageway to avoid downstream damage caused by said arterial debrisbeing carried into a body blood stream.
 18. The catherization method ofclaim 17 above, wherein said dye is an X-Ray contrast dye.
 19. Thecatherization method of claim 17 above, wherein the step of thermallycutting is accomplished by an IR laser irradiating through IR opticalfibers to heat said cutting tip.
 20. The catherization method of claim17 above, wherein physical and thermal damage to said arterial walls isprevented by molding plural arterial guards into an outer surface ofsaid catherization system.
 21. A catherization system for removingarterial blockage from an artery, which comprises: thermal means forremoving said arterial blockage from inner walls of said artery;cylindrical tube means for carrying said thermal means to said arterialblockage in said artery, and for applying a vacuum to evacuate arterialdebris created by said thermal means; and IR optical fiber meanspneumatically sealed within said cylindrical tube means and abuttingsaid thermal means for applying IR radiation to heat said thermal meansto a desired cutting temperature.
 22. An arterial catherization systemfor removing arterial blockage from an artery, which comprises: acylindrical tube having a longitudinal passageway and at least one port;an annular tip axially aligned and abutting the cylindrical tube toeffect a thermal cutting of the arterial blockage and to provide anentry into the longitudinal passageway for removing arterial debris; andplural optical fibers pneumatically sealed within and extending along alongitudinal axis of the cylindrical tube, and abutting the annular tipto accommodate a heating of the annular tip to a thermal cuttingtemperature, where the system is designed to support a first blood flowto downstream body tissue around an outer surface of the cylindricaltube and to support a second blood flow through an interior of thecylindrical tube and where the first blood flow is opposite in directionto the second blood flow.
 23. The arterial catherization system of claim22, wherein removal of the arterial debris occurs through a vacuum inthe longitudinal passageway designed to support the second blood flow.24. The arterial catherization system of claim 22, further comprising:arterial guards formed into and extending from the outer surface of thecylindrical tube to separate inner walls of the artery from the annulartip and outer walls of the cylindircal tube designed to separae theinner walls of the artery from thermal damage from the annular tip andthe outer surface of the cylindrical tube.
 25. The arterialcatherization system of claim 22, wherein the plural optical fibers areIR optical fibers.
 26. The arterial catherization system of claim 22,wherein the annular tip is longitudinally separated from the cylindricaltube to provide alternative pathways for blood to enter the longitudinalpassageway.
 27. The arterial catherization system of claim 22, whereinthe annular tip has a first circumference adjacent the cylindrical tubewhich is smaller than a second circumference of the annular tip which isfurther most from the cylindircal tube.
 28. The arterial catherizationsystem of claim 27, wherein the first circumference remains constantalong the longitudinal axis a first distance and thereafer progressivelyincreases to the second circumference, thereby providing an extendedcutting surface to avoid clogging by the arterial debris.
 29. Acatherization method for removing blockage from an artery withoutdamaging interior artery walls, which comprises the following steps:inserting dye into the artery to pinpoint position to the blockagethrough X-Ray exposure; inserting a guidewire into the artery to extendthrough the blockage; advancing a catherization system having a centralpassageway and a thermal cutting tip along the guidewire to abut theblockage, where the system is designed to support a first blood flow todownstream body tissue around an outer surface of the cylindrical tubeand to support a second blood flow through an interior of thecylindrical tube and where the first blood flow is opposite in directionto the second blood flow; thermally cutting through the blockage byirradiating the cutting tip without damaging arterial walls; andremoving arterial debris resulting from the above step of thermallycutting by creating a vacuum in the central passageway to avoiddownstream damage caused by the arterial debris being carried into abody blood stream and the support the second blood flow.
 30. Thecatherization method of claim 29, wherein the dye is an X-Ray contrastdye.
 31. The catherization method of claim 29, wherein the step ofthermally cutting comprises irradiating the cutting tip with radiationan IR laser through the IR optical fibers, which resulting in heating ofthe cutting tip.
 32. The catherization method of claim 29, whereinphysical and thermal damage to the arterial walls is prevented bymolding plural arterial guards into an outer surface of thecatherization system.
 33. A catherization system for removing arterialblockage from an artery, which comprises: thermal means for removing thearterial blockage from inner walls of the artery; cylindsrical tubemeans for carrying the thermal means to the arterial blockage in theartery, and for applying a vacuum to evacuate arterial debris created bythe thermal means, where the cylindrical means supports a blood flow todownstream body tissue around an outer surface of the cylindrical tube;and IR optical fiber means pneumatically sealed within the cylindricaltube means and abutting the thermal means for applying IR radiation toheat the thermal means to a desired cutting temperature.